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National Early Warning Score 2 (NEWS2)

2017 update of NEWS with a hypercapnic SpO2 scale and confusion in the ACVPU item.

National Early Warning Score 2 (NEWS2)
Respiratory rate
/min
SpO2 scale
Oxygen saturation
%
On supplemental oxygen
Temperature
C
Systolic blood pressure
mmHg
Heart rate
bpm
Consciousness (ACVPU)
Complete the fields above to see the result.

When to use

  • Adult early-warning scoring, with Scale 2 for patients with target saturations of 88-92% (e.g. chronic hypercapnic respiratory failure).

Formula

As NEWS but SpO2 uses Scale 1 or Scale 2, supplemental O2 adds 2, and new-onset Confusion scores 3 in the ACVPU item. Low 0-4, medium 5-6 or any single 3, high >=7.

Pearls and pitfalls

  • Use Scale 2 only for patients with a clinically agreed 88-92% target; misapplying it under-scores hypoxaemia.
  • New confusion or delirium now scores in the consciousness item.

References

  1. Royal College of Physicians. National Early Warning Score (NEWS) 2. London: RCP; 2017.